本文選題：癌癥　切入點：乳腺癌　出處：《南京大學》2017年碩士論文　論文類型：學位論文

【摘要】：研究目的:淋巴結(jié)轉(zhuǎn)移是癌細胞重要的轉(zhuǎn)移方式之一,同機體淋巴結(jié)內(nèi)免疫功能的下降有著密切的聯(lián)系。大量研究證實腫瘤引流淋巴結(jié)內(nèi)的免疫細胞特別是T細胞會出現(xiàn)數(shù)量下降、結(jié)構成分改變,進而導致其免疫功能受損。本文通過實驗觀察對比無淋巴結(jié)轉(zhuǎn)移癌癥患者引流區(qū)淋巴結(jié)與有淋巴結(jié)轉(zhuǎn)移癌癥患者腫瘤引流淋巴結(jié)(tumor draining lymph node,TDLN)內(nèi)T細胞亞群的量,分析其免疫功能的差別,并通過實驗研究白細胞介素-2(Interleukin-2,IL-2)對腫瘤引流淋巴結(jié)內(nèi)T細胞亞群的影響,探討白細胞介素-2成為提高癌癥患者淋巴結(jié)免疫功能藥物的可能性。研究方法:1.我們納入2016年5月1日-12月31日期間來我院診治乳腺癌(breast cancer,BC)及甲狀腺癌(thyroid cancer,TC)患者,根據(jù)術后病理分為對照組及觀察組,其中對照組(13例,乳腺癌7例,甲狀腺癌6例)為術后病理確診淋巴結(jié)癌轉(zhuǎn)移病人;觀察組(13例,乳腺癌6例、甲狀腺癌7例)為術后病理確診無淋巴結(jié)癌轉(zhuǎn)移病人。取得患者術中常規(guī)清掃淋巴結(jié),采用免疫組化(Immunohistochemistry,IHC)中免疫熒光技術(Immunofluorescence,IF)測定淋巴結(jié)內(nèi)CD3+CD4+T細胞、CD3+CD8+T細胞的量,采用酶聯(lián)免疫吸附測定法(ELISA法)測定淋巴結(jié)內(nèi)由CD3+CD4+T細胞(Th細胞)分泌的白介素-2、白介素-4(Interleukin-4,IL-4)的濃度。用T檢驗比較兩組CD3+CD4+T細胞、CD3+CD8+T細胞及CD3+CD4+T細胞分泌的IL-2、IL-4的差異,并分析造成兩組患者淋巴結(jié)免疫功能差異的原因。2.納入2016年5月1日-12月31日期間來我院診治乳腺癌及甲狀腺癌患者,根據(jù)術后病理分為實驗A組及實驗B組,其中實驗A組(11例,乳腺癌6例、甲狀腺癌5例)為術前使用白介素-2治療,術后病理確診淋巴結(jié)癌轉(zhuǎn)移病人;實驗B組(11例,乳腺癌4例、甲狀腺癌7例)為術前使用白介素-2治療,術后病理確診無淋巴結(jié)癌轉(zhuǎn)移病人。取得患者術中常規(guī)清掃淋巴結(jié),采用免疫組化中免疫熒光技術測定淋巴結(jié)內(nèi)CD3+CD4+T細胞、CD3+CD8+T細胞的量,采用酶聯(lián)免疫吸附測定法測定淋巴結(jié)內(nèi)由CD3+CD4+T細胞(Th細胞)分泌的IL-2、IL-4的濃度。用T檢驗比較各組CD3+CD4+T細胞、CD3+CD8+T細胞及CD3+CD4+T細胞分泌的IL-2、IL-4的差異,并分析各組患者淋巴結(jié)免疫功能差異的原因,探討白介素-2成為提高癌癥患者淋巴結(jié)免疫功能藥物的可能性。研究結(jié)果:1.觀察組淋巴結(jié)CD3+CD4+T細胞、CD3+CD8+T細胞及CD3+CD4+T細胞分泌的IL-2、IL-4的測量值均高于對照組,且有統(tǒng)計學意義(P0.05)。2.實驗A組淋巴結(jié)CD3+CD4+T細胞、CD3+CD8+T細胞及CD3+CD4+T細胞分泌的IL-2、IL-4的測量值均高于對照組,且有統(tǒng)計學意義(P0.05);實驗B組淋巴結(jié)CD3+CD4+T細胞、CD3+CD8+T細胞及CD3+CD4+T細胞分泌的IL-2、IL-4的測量值均高于觀察組,且有統(tǒng)計學意義(P0.05);實驗B組淋巴結(jié)CD3+CD4+T 細胞、CD3+CD8+T 細胞及 CD3+CD4+T 細胞分泌的 IL-2、IL-4 的測量值均高于實驗A組組,且有統(tǒng)計學意義(P0.05)。結(jié)論:無淋巴結(jié)轉(zhuǎn)移癌癥患者其腫瘤引流區(qū)內(nèi)淋巴結(jié)的免疫功能明顯強于有淋巴結(jié)轉(zhuǎn)移癌癥患者的腫瘤引流淋巴結(jié),而應用白介素-2后可以明顯提升淋巴結(jié)內(nèi)T細胞亞群的量,提高其免疫力從而起到抗腫瘤作用,白介素-2有望成為提高腫瘤引流淋巴結(jié)免疫力、輔助癌癥治療的藥物。
[Abstract]:Objective: lymph node metastasis is one of the important way of the transfer of cancer cells, with the decline in immune function in lymph nodes are closely linked. A large number of studies have demonstrated that tumor draining lymph nodes in the immune cells, especially T cells will be a decline in the number of components change, thus resulting in impaired immune function. In this paper, through the experiment comparative observation of lymph node metastasis in patients with cancer draining lymph nodes and lymph node metastasis in patients with cancer tumor draining lymph node (tumor draining lymph node, TDLN) in T cell subsets, analyze the immune function difference, and through the experimental study of interleukin -2 (Interleukin-2, IL-2) on tumor draining effect the lymph nodes of T cell subsets, investigate interleukin -2 become the possibility of improving the immune function of drugs in patients with lymph node cancer. Methods: We included 1. -12 month May 1, 2016 31 date To our hospital for diagnosis and treatment of breast cancer (breast, cancer, BC) and thyroid cancer (thyroid cancer, TC) patients, according to postoperative pathology were divided into control group and observation group, the control group (13 cases, 7 cases of breast cancer, 6 cases of thyroid carcinoma) for patients pathologically confirmed lymph node metastasis after operation; the observation group (13 cases, 6 cases of breast cancer, 7 cases of thyroid carcinoma) for pathological diagnosis of lymph node metastasis patients. Routine lymph node dissection in patients, using immunohistochemistry (Immunohistochemistry, IHC) in the immunofluorescence technique (Immunofluorescence, IF) detection of CD3+CD4+T cells in lymph nodes, CD3+CD8+T cells the amount of enzyme linked immunosorbent assay (ELISA) determination of lymph nodes by CD3+CD4+T cells (Th cells) secretion of interleukin -2, interleukin -4 (Interleukin-4, IL-4). The concentration of T test between two groups of CD3+CD4+T cells and secretion of CD3+CD8+T cells and CD3+CD4+T cells in IL-2, IL The differences in -4, and analyze the cause of two groups of patients with lymph node.2. immune function of the difference in the May 1, 2016 -12 month 31 days during our hospital diagnosis and treatment of breast cancer and thyroid cancer patients, according to postoperative pathology were divided into experimental group A and experimental group B, experimental group A (11 cases, 6 cases of thyroid, breast cancer 5 cases of cancer) for interleukin -2 therapy before surgery, patients with pathologically confirmed lymph node metastasis after operation; group B (11 cases, 4 cases of breast cancer, 7 cases of thyroid carcinoma) for interleukin -2 in the treatment of preoperative, postoperative pathological diagnosis of lymph node metastasis patients. Conventional dissection the patient in operation, the immune group of CD3+CD4+T cells in lymph nodes by immunofluorescence technique in CD3+CD8+T cells, the amount of adsorption were determined by CD3+CD4+T cells in lymph nodes by ELISA (Th cells) the secretion of IL-2, the concentration of IL-4. T test groups were compared with CD3+CD4+T cells, CD The secretion of 3+CD8+T cells and CD3+CD4+T cells IL-2, IL-4 difference, and analysis of each group of lymph nodes in patients with immune function difference, investigate interleukin -2 become the possibility of improving the immune function of drugs in patients with lymph node cancer. Results: the observation group of 1. lymph nodes in CD3+CD4+T cells, CD3+CD8+T cells and CD3+CD4+T cells secrete IL-2, IL-4 measurement the value is higher than the control group, and there was statistical significance (P0.05) CD3+CD4+T cells in the experimental group A lymph node.2., secretion of CD3+CD8+T cells and CD3+CD4+T cells IL-2, IL-4 measured values were higher than the control group, and there was statistical significance (P0.05); experimental group B lymph node CD3+CD4+T cells, secretion of CD3+CD8+T cells and CD3+CD4+T cells IL-2 IL-4, the measured values were higher than those in the observation group, and there was statistical significance (P0.05); experimental group B lymph node CD3+CD4+T cells, CD3+CD8+T cells and CD3+CD4+T cells to secrete IL-2, IL-4 The measured values were higher than the experimental group A, and there was statistical significance (P0.05). Conclusion: the lymph node metastasis in patients with cancer of the immune function in tumor draining lymph node was significantly higher in the cancer patients with lymph node metastasis of tumor draining lymph node, and the application of interleukin -2 can significantly enhance the lymph node in T cells the amount of subsets, so as to improve the immunity of antitumor effect of interleukin -2 to improve tumor draining lymph node immunity adjuvant in the treatment of cancer.

【學位授予單位】：南京大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R730.5
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本文編號：1601149